1. Histopathology of Allergic Fungal Rhinosinusitis Versus Chronic Rhinosinusitis with Nasal Polyps.
- Author
-
Simpson T, Talati V, Baird AM, Gattuso P, Allen-Proctor MK, Papagiannopoulos P, Batra PS, Filip P, and Tajudeen BA
- Subjects
- Humans, Male, Female, Retrospective Studies, Chronic Disease, Middle Aged, Adult, Rhinitis, Allergic microbiology, Rhinitis, Allergic complications, Rhinitis, Allergic pathology, Mycoses complications, Eosinophils pathology, Endoscopy methods, Allergic Fungal Sinusitis, Rhinosinusitis, Sinusitis microbiology, Sinusitis pathology, Sinusitis complications, Nasal Polyps microbiology, Nasal Polyps complications, Nasal Polyps pathology, Rhinitis microbiology, Rhinitis pathology, Rhinitis complications
- Abstract
Objective: Structured histopathology (SHP) is a method of analyzing sinonasal tissue to characterize endotypes of chronic rhinosinusitis with nasal polyps (CRSwNP). Allergic fungal rhinosinusitis (AFRS) shares several features with certain endotypes of CRSwNP. Our objective was to compare the histopathology of AFRS and eosinophilic CRSwNP to further understand whether they are separate endotypes or disease entities altogether., Methods: A retrospective review of AFRS and CRSwNP patients undergoing endoscopic sinus surgery was performed. Data were collected on demographics, comorbidities, subjective and objective severity scores, and 13-variable SHP reports. CRSwNP patients with >10 eosinophils per high-power field (eCRSwNP) were included. Chi-squared and t-tests were used for statistical analysis., Results: A total of 29 AFRS and 108 eCRSwNP patients were identified. AFRS patients were younger and more often Black. Symptom severity scores (SNOT-22, Lund-MacKay, and Lund-Kennedy) were uniform between groups. AFRS patients had a higher rate of Charcot-Leyden crystals (41.4% vs. 10.2%; p < 0.001). Severe degree of inflammation, eosinophilic inflammatory predominance, eosinophil aggregates, subepithelial edema, and basement membrane thickening were common in both groups, and their rates were not statistically significantly different between groups. Metaplasia, ulceration, fibrosis, and hyperplastic/papillary change rates were low (<30%) and similar between groups., Conclusion: The SHP of eCRSwNP and AFRS are highly consistent, which suggests AFRS is a severe subtype of CRSwNP overall rather than a separate disease entity. This also lends credence to AFRS belonging on the endotypic spectrum of CRSwNP., Level of Evidence: 3 Laryngoscope, 134:2617-2621, 2024., (© 2023 The American Laryngological, Rhinological and Otological Society, Inc.)
- Published
- 2024
- Full Text
- View/download PDF